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yam, co~ <br />a-~$ COLORADOrDIRISIONDOF MINERALS AeND6GEOLOG~EC~IVE~ <br />._ ._ ._._ -MAl`- - __. <br />__ _ __. _- --__.._ ---- 4 3 2005 <br />APPLICATION FORM FOR A REVISION O~V~s~O°0/MineralsBGepl~y <br />TO A COAL MINING AND RECLAMATION PERMIT <br />This form must be completed and submitted with all requests for minor revisions, as defined in Rule 1.04(73), <br />technical revisions, as defined in Rule 1.04(136), and permit revisions, as defined in Rule 1.04(90). AN revisions <br />are to address the requirements of aule 2.08.4. Three (3) copies of the revision, including maps, must be <br />submitted in order for it to be complete. <br />All revisions are to be formatted so they can be inserted into the permit to replace the revised sections, maps, <br />tables and/or figures, with a revised table of contents, if necessary. The revision submittal date should be printed <br />in the lower right comer of each revision page. A cover letter to the revision should explain the nature of the <br />revision and reference the specific permit sections being revised. <br />For federal mines, a copy of the revision application must be submitted to all agencies on the federal mailing list <br />(except OSM) at the same Gme the application is submitted to the Division, and proof of distribution must be <br />submitted to the Division along with the application. Copies of revision pages modified during the review process <br />must be distributed in the same manner, along with proof of distribution. Proof of distribution must be submitted <br />prior to implementation of the revision. <br />Permit No.: C - 1981 - 028 Date: 04 / 29 / 2005 <br />Pennittee: Coors Energy Company <br />Street: P.O. Box 467 <br />City: <br />Golden <br />State: CO Zip Code: 80402 _ 0467 <br />Brief Description of Revision: Change Approved Post-Mining Land <br />Use -Partial <br />Public Notice Attached: Yes / No (Required for PRs and TRs) <br />Bond Increase: Yes No / Federal Non-Federa! ~ Mine <br />Proposed Change in: <br />Permit Area - <br />Disturbed (+/-) _ _ o _ o gcres <br />Permit (+/-) _ _ o . o Acres <br />Affected (+/_) _ _ 0 o Acres <br />Mineral Ownership - <br />MineralPrivate (+/-) _ _ 0. ~ Acres <br />Mineral Federal (+/-) _ _ 0 0 Acres <br />Surface Ownership - <br />Private Land (+/_) _ _ o o Acres <br />Federal Land (+/-) _ _ o o Acres <br />State Land (+/-) _ _ 0 . ~ Acres <br />Mineral State (+/-) _ - 0 0 Acres <br />